Is Intranasal Ketamine Safe and Effective as a Prehospital Analgesic?

Brett H Shaw 1, Marshall Ross 1

CJEM 2020 Jan;22(1):31-32

ABSTRACT

Background: Primary care paramedics in British Columbia, Canada, have limited analgesic options other than nitrous oxide when transporting patients. Ketamine can be an effective analgesic when dosed appropriately.

Objective: The aim of this study was to compare the improvement in pain scores between intranasal ketamine and placebo when added to baseline inhaled nitrous oxide.

Design: Single-centre randomized double blind control trial.

Setting: Out-of-hospital patients being cared for by primary care paramedics dispatched from a single station.

Subjects: Out-of-hospital patients with acute pain who reported a verbal numeric rating scale pain score ≥ 5, and who wished to receive analgesia.

Intervention: 0.75 mg/kg intranasal ketamine v. placebo, both in addition to baseline nitrous oxide administration.

Outcomes: Primary outcome was the proportion of patients experiencing a reduction in verbal numeric rating scale score ≥ 2 at 30 minutes.